It can be a challenge to differentiate NMS and Serotonin syndrome, careful attention to historical factors, a thorough medication history, and a detailed physical exam and neurologic exam is necessary to quickly diagnose these patients. This post details the presentation of each entity and highlights the differences between the two.
Read MoreIt was another exciting week here in Cincinnati as we kicked off grand rounds with a session on performance improvement during our quarterly leadership curriculum with Dr. McDonough and discussed alternatives to hospital admission and available outpatient resources in the era of high boarding with our Chair, Dr. Pancioli. We finished our day with an excellent discussion on prenatal mental health care with Dr. Wolochatiuk in her R4 Case Follow Up and on uncommon causes of disorientation in Dr. Zalesky’s Taming the SRU lecture.
Read MoreEnjoy this week’s Grand Round’s Recap. Dr. Murphy started us off with a great Morbidity and Mortality conference with a variety of fascinating cases. Next, Dr. LaFollette taught us some pearls for HEENT emergencies if you are out in the community. Dr. Hunt took us through transfusion reactions and how to manage them, followed by Dr. Hall discussing the management pearls of Nonconvulsive Status Epilepticus. Next, Dr. Connelly taught us how we can incorporate alternative EKG leads into our practice, and Dr. Klaszky finished our day with a nuanced take of how to manage refractory septic shock. It was a jam packed day full of great learning!
Read More'Twas a fantastic grand rounds. Drs. Banning and Golden started it off taking us through the most recent evidence for management of sub-massive and massive PE, as well as presenting their algorithm to be published on Emergency KT. This was followed by a global health lecture given by Dr. Lagasse, which covered a range of re-emerging infectious diseases. Next, Dr. Bryant took us through multiple pediatric cases, and discussed her approach in determining whether to discharge, transfer, or treat pediatric patients with common / representative complaints. Dr. Adeoye then took us through the history and development of our current approach to the management of acute ischemic stroke. Dr. LaFollette then took us through an evidence based approach to removing things from where they shouldn't be in his edition of mastering minor care, discussing approaches to removing retained objects from ears and skin. We then finished the conference with two interesting cases: One presented by Dr. Sabedra that was followed by a discussion on the diagnosis and management of massive hemoptysis, and the other presented by Dr. Dang illustrating the differences and similarities hyperthermic toxidromes including NMS and serotonin syndrome as well as their management.
Read MoreThis week, Dr. Boyer led us through his R4 case follow up. Drs. Baez and Summers dove deep into the literature on sepsis. Dr. Gauger reviewed toxicologic syndromes. Dr. Axelson hit us with some trauma pearls and we worked through sick respiratory cases during our combined Peds-EM sim.
Read MoreTracheoinnominate Fistula
One of the most dreaded days in the ED, a post-trach patient presents with a small bleed that stopped, is this one of 50% of patients with a TI fistula waiting to unleash?
Once the patient starts massively bleeding - what's your next move hotshot?
SRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
